Technical ReportGender trends in authorship of spine-related academic literature—a 39-year perspective
Introduction
In 2015, women made up 52% of all matriculating medical students; however, women constitute only 14.8% and 17.3% of orthopedic and neurosurgery residents [1]. This disparity is even more pronounced in practicing physicians because, although 34% of practicing physicians are women, only 4.6% and 7.4% of practicing orthopedic surgeons and neurosurgeons are women [2], [3]. Furthermore, the percentage of women in spine surgery is lower than in any other orthopedic subspecialty [3].
This underrepresentation has been widely acknowledged and thought to be attributable to, among other factors, poor exposure to surgical subspecialties in medical student education, ongoing misperceptions about orthopedic surgery, and unconscious sex biases [4]. Female physician awardees of National Institute of Health career development awards report experiencing gender bias and sexual harassment [5]. In surveys of academic literature, there exists a “gender gap” in the representation of women as authors, especially in surgical literature with women rarely publishing as senior author (4%–6% of articles) [6], [7].
Over time, efforts have been made toward promoting gender diversity in regard to promotions and leadership opportunities; however, the progress of female representation within the field of spine-related research has not been previously described. Thus, the goals of this study were to determine how gender trends in authorship of spine-related academic literature have changed over the past 39 years. We hypothesize that although women are still less likely to take leadership roles as first or last author, the gender gap has decreased over time.
Section snippets
Data source
Citation data from 33,002 articles published between 1978 and 2016 in five peer-reviewed spine research journals (European Spine Journal [ESJ], The Spine Journal [SpineJ], Spine, Journal of Spinal Disorders and Techniques [now known as Clinical Spine Surgery; JSDT/CSS], and Journal of Neurosurgery: Spine [JNS]; Table 1) were extracted and retrieved from PubMed. Data elements included PubMed ID, journal name, article title, type of article, date of publication, and complete author listing. A
Prevalence of female authorship
Overall female representation increased over time from 7.3% (1978–1994) to 18.5% (2010–2016, p<.001; Fig. 1). Female representation increased for both first and senior authorships from 6.5% and 4.7% (1978–1994) to 18.5% and 13.6% (2010–2016, p<.001). Middle authorship experienced growth from 6.4 to 18.3% (p<.001). Growth in female senior author representation declined after 2000 (12.3% vs. 12.9% vs. 13.5% between 2000–2004, 2005–2009, and 2010–2016) relative to overall authorship participation
Discussion
In this study, we show that women continue to be underrepresented in academic spine literature. However, over the last 4 decades, there has been increasing involvement of female authors. Although there continues to be differences in the frequency with which women publish as first or senior author, as well as the sheer number of publications per unique author, these differences trend toward more gender parity. Although women continue to be underrepresented in the literature, these trends point
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Author disclosures: DCS: Nothing to disclose. DJ: Nothing to disclose. DO: Nothing to disclose.